N‐terminal pro‐brain natriuretic peptide level determined at different times identifies transient ischaemic attack patients with atrial fibrillation

Purroy, Francisco; Suárez-Luis, I; Mauri-Capdevila, Gerard; Cambray, Serafí; Farré, Joan; Sanahuja, Jordi; Piñol‐Ripoll, Gerard; Quílez, Alejandro; González-Mingot, Cristina; Begué, R.; Gil, Myung Cheol; Fernández, Elena; Benabdelhak, Ikram

doi:10.1111/ene.12222

Cited by 17 publications

(18 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Because of unavailability of the requested data or lack of response from authors, we finally selected 23 articles (Figure 1). [16][17][18][19][20][21][22][23][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] The median quality score was 9 (minimum=5 and maximum=11; data not shown). These 23 included articles corresponded to 18 different cohorts of patients, 16 of which had data from patients with a defined cause (cardioembolic, LAA, or SVD) and 2 cohorts containing data of undetermined patients only.…”

Section: Resultsmentioning

confidence: 93%

“…15 This relation between pro-BNP and atrial dilatation explains the clear association of elevated BNP/NT-proBNP with the presence of AF 15 and cardioembolic stroke. [16][17][18][19][20][21][22][23] Both natriuretic peptides have been associated with cardioembolic stroke in several, but generally small studies, [16][17][18][19][20][21][22][23] reporting different cutoff points to distinguish cardioembolic from noncardioembolic stroke and considering different time points from symptoms onset. A clear association of BNP/NT-proBNP with cardioembolic stroke cause would allow to complement and speedup the diagnosis of cardioembolism stroke especially in the most challenging cases (ie, paroxysmal AF) and might aid to reduce the rate of undetermined strokes.…”

mentioning

confidence: 99%

See 1 more Smart Citation

B-Type Natriuretic Peptides Help in Cardioembolic Stroke Diagnosis

Llombart

Antolin-Fontes

Bustamante

et al. 2015

Stroke

139

View full text Add to dashboard Cite

Background and Purpose-Determining the underlying cause of stroke is important to optimize secondary prevention treatment. Increased blood levels of natriuretic peptides (B-type natriuretic peptide/N-terminal pro-BNP [BNP/ NT-proBNP]) have been repeatedly associated with cardioembolic stroke. Here, we evaluate their clinical value as pathogenic biomarkers for stroke through a literature systematic review and individual participants' data meta-analysis. Methods-We searched publications in PubMed database until November 2013 that compared BNP and NT-proBNP circulating levels among stroke causes. Standardized individual participants' data were collected to estimate predictive values of BNP/NT-proBNP for cardioembolic stroke. Dichotomized BNP/NT-proBNP levels were included in logistic regression models together with clinical variables to assess the sensitivity and specificity to identify cardioembolic strokes and the additional value of biomarkers using area under the curve and integrated discrimination improvement index. Results-From 23 selected articles, we collected information of 2834 patients with a defined cause. BNP/NT-proBNP levels were significantly elevated in cardioembolic stroke until 72 hours from symptoms onset. Predictive models showed a sensitivity >90% and specificity >80% when BNP/NT-proBNP were added considering the lowest and the highest quartile, respectively. Both peptides also increased significantly the area under the curve and integrated discrimination improvement index compared with clinical models. Sensitivity, specificity, and precision of the models were validated in 197 patients with initially undetermined stroke with final pathogenic diagnosis after ancillary follow-up. Conclusions-Natriuretic peptides are strongly increased in cardioembolic strokes. Future multicentre prospective studies comparing BNP and NT-proBNP might aid in finding the optimal biomarker, the best time point, and the optimal cutoff points for cardioembolic stroke identification. 2 Patients with cardioembolic stroke are treated with anticoagulant drugs, whereas antiplatelet agents are the treatment of choice for patients with large artery atherosclerosis (LAA) stroke and small vessel disease (SVD).3 Cardioembolic strokes are generally more severe and more prone to recurrence than LAA or SVD and account for approximately one fifth of ischemic strokes. 4 However, in spite of the importance of an accurate etiopathogenic classification, the cause of ≈35% of patients remains undetermined, even after complete evaluation.5 This group of patients presents a rate of recurrence of ≈30% during the first year after the event, partly explained by an inappropriate secondary prevention treatment.6 Stroke of undetermined cause is an heterogeneous group that includes patients with 2 or more potential causes of stroke, patients with <50% of stenosis and patients with a negative diagnostic workup.7 From the latter, a negative diagnostic might be caused by a transitory or reversible condition which is difficult to detect, such as a...

show abstract

Section: Resultsmentioning

confidence: 93%

mentioning

confidence: 99%

B-Type Natriuretic Peptides Help in Cardioembolic Stroke Diagnosis

Llombart

Antolin-Fontes

Bustamante

et al. 2015

Stroke

139

View full text Add to dashboard Cite

show abstract

“…NT‐proBNP coexists in circulation with brain natriuretic peptide (BNP) in equal proportion. It has been associated with the diagnosis of atrial fibrillation among TIA patients and with poor prognosis after ischaemic stroke . Finally, copeptin is a peptide of 39 amino acids in the C‐terminal part of pro‐vasopressin, is secreted together with vasopressin during processing of the precursor peptide by the neurohypophysis upon hemodynamic or osmotic stimuli and is involved in the endocrine stress response like brain ischaemia .…”

Section: Discussionmentioning

confidence: 99%

The determination of copeptin levels helps management decisions among transient ischaemic attack patients

et al. 2015

Self Cite

View full text Add to dashboard Cite

show abstract

“…Our prospective study evaluated the correlation of a panel of different biomarkers with infarct size. We combined biomarkers of in ammation, atrial dysfunction and neuronal and glial dysfunction [5][6][7] and observed that IL-6 and S100b levels were able to independently predict infarct volume. In contrast to the other biomarkers, their correlation remained unchanged after the multivariate analyses adjusted for stroke aetiology.…”

Section: Discussionmentioning

confidence: 99%

Basal IL-6 and S100b levels predict infarct volume in acute ischaemic stroke patients

Purroy

Farre-Rodriguez

Mauri-Capdevila

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The study of biomarkers related to the infarct volume of acute ischaemic stroke (AIS) is a valuable clinical strategy. We conducted a prospective study to evaluate the relationship between a wide panel of biomarkers involved in different biochemical pathways and lesion volume. Methods: We studied 332 patients with AIS. Infarct volume was calculated from diffusion weighted imaging (DWI). Blood samples were drawn within 24 h of symptom onset to test a panel of biomarkers that included high-sensitivity C-reactive protein (hs-CRP), IL-6, neuron-specific enolase (NSE), N-terminal pro-B-type natriuretic peptide (NT-ProBNP), S100b, troponin and IL-10. Results: The median lesion volume was 2.5 cc (IQR: 0.6-15.3). Patients with previous atrial fibrillation, cardioembolic aetiology and total anterior circulation infarct TACI classification had higher lesion volumes than those without them. Patients with previous recent TIA had smaller ischemic lesions than those without it. Age and NIHSS were significantly correlated with lesion volume. In a lineal regression analysis adjusted by aetiology, S100b and IL-6 emerged as the only biomarkers that could independently predict infarct volume. In contrast, previous recent TIA and small vessel disease were inversely related to infarct volume. Conclusion: The correlation between the two blood marker levels and ischemic lesion volume would support the use of these biomarkers as a surrogate endpoint in AIS, especially in centres without DWI 24/7. Our findings should be further explored in larger, preferably multicentre studies.

show abstract

N‐terminal pro‐brain natriuretic peptide level determined at different times identifies transient ischaemic attack patients with atrial fibrillation

Abstract: High levels of NT-proBNP determined during the first 3 months after a TIA were associated with AF. Consequently, this biomarker may be useful to reclassify undetermined TIA patients as having disease of CE.

Cited by 17 publications

References 15 publications

B-Type Natriuretic Peptides Help in Cardioembolic Stroke Diagnosis

B-Type Natriuretic Peptides Help in Cardioembolic Stroke Diagnosis

The determination of copeptin levels helps management decisions among transient ischaemic attack patients

Basal IL-6 and S100b levels predict infarct volume in acute ischaemic stroke patients

Contact Info

Product

Resources

About